On the Night Shift, Doctor Thrives on Teamwork – and All Those Babies
One in an ongoing series.
It’s the middle of the night at Einstein Medical Center Montgomery. The hubbub of the day has receded and the hospital is quiet. But there are babies ready to be born, and Daryl Stoner, MD, is there to escort them on their journey.
Dr. Stoner, an obstetrician, is a nocturnist, a hospital-based physician who works at night. She works 8 p.m. to 8 a.m. three nights a week, delivering babies in the maternity ward. As one of the few attending physicians on night duty at the hospital, she also oversees the admission of acutely ill patients who come through the Emergency Department.
Most doctors work daytime hours. A nocturnist takes care of their patients in the hospital at night and limits the need for the doctors to be on call. Nocturnists are becoming increasingly common in hospitals. For the most part, the babies Stoner delivers are the patients of other obstetricians, except for the few patients she’s maintained in a small, one-morning-a-week practice.
Dr. Stoner began working overnights in 2016, seeking liberation from the record-keeping and other non-medical tasks of private practice that kept her in her office hours after her last patient had gone.
She’s traded that for a nurturing subculture in which the camaraderie and familiarity of working with the same team most of the time provides a smooth, streamlined approach to patient care. “There’s always a physician and a midwife on, and we have an amazing team of night nurses,” Dr. Stoner says.
They trust and rely on each other and the team cohesion provides back-up in every situation. “We can be very fluid about who’s taking care of what and what needs to be done, so I feel we provide much more comprehensive care for the patient,” she says.
The overnight work can be busy – sometimes eight babies can be born during a shift and sometimes none at all – but it isn’t chaotic. Patient care is simplified in the absence of the multiple practitioners who are present during the day.
“It’s only us, so there’s no question who to call, there’s not a lot of people to involve in a discussion. There’s autonomy and there’s more control,” Stoner says.
Stoner chose to be an obstetrician because “you really can get to know your patients and you get to actually do something good,” she says. “And it’s the only time patients come to the hospital and they are happy about it.” She’s maintained a few patients from her years in private practice and sees them during office hours Friday mornings.
Stoner’s two daughters are grown and on their own, so the night work doesn’t necessarily provide more family time. She appreciates the ability, though, to have dinner with her husband before she leaves for the overnight shift.
“It’s hard to leave the people at home, but it’s balanced by the feeling that you’re part of a team,” she says. “The nurses have already been there an hour when I arrive and have a sense of the patients. And sometimes I’ll come in and they’ll say, ‘We know what you’re going to do about this patient,’ and they’re usually right.”
Stoner says she isn’t, by nature, a night person. Like others who work overnight or shift work, nocturnists often struggle with a disruption in their natural circadian rhythms.
And that explains Stoner’s description of what she does with her time off. While she does tend the garden at her Chestnut Hill home, and is learning to weave on a loom she just purchased, mostly, she says, “I sleep.”